title: Robot-assisted laparoscopic vs open radical cystectomy: comparison of complications and perioperative oncological outcomes in 200 patients.
abstract: OBJECTIVE
  To compare perioperative morbidity and oncological outcomes of robot-assisted laparoscopic radical cystectomy (RARC) to open RC (ORC) at a single institution.
  
  
  METHODS
  A retrospective analysis was performed on a consecutive series of patients undergoing RC (100 RARC and 100 ORC) at Wake Forest University with curative intent from 2006 until 2010. Complication data using the Clavien system were collected for 90 days postoperatively. Complications and other perioperative outcomes were compared between patient groups.
  
  
  RESULTS
  Patients in both groups had comparable preoperative characteristics. The overall and major complication (Clavien ≥ 3) rates were lower for RARC patients at 35 vs 57% (P = 0.001) and 10 vs 22% (P = 0.019), respectively. There were no significant differences between groups for pathological outcomes, including stage, number of nodes harvested or positive margin rates.
  
  
  CONCLUSIONS
  Our data suggest that patients undergoing RARC have perioperative oncological outcomes comparable with ORC, with fewer overall or major complications. Definitive claims about comparative outcomes with RARC require results from larger, randomised controlled trials.
authors.affiliation: Division of Urology, UC San Diego Heath System, San Diego, CA, USA.
authors.forename: A Karim
authors.initials: AK
authors.lastname: Kader
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Richards
authors.forename: L Spencer
authors.initials: LS
authors.lastname: Krane
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Pettus
authors.forename: John J
authors.initials: JJ
authors.lastname: Smith
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Hemal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
keywords: bladder cancer; complications; cystectomy; laparoscopy; outcomes; robotics